The NDIA has released the Annual Pricing Review (APR) 2026-27 and Pricing Schedule in quick succession, with a raft of expected (and some not-so-expected) changes. In these turbulent times, we’re sharing what these changes mean for your claiming practices.

What’s changing?

There’s a mixture of good and bad:

• The SCHADS minimums are passed on in full for disability support work, with $73.58 now the base hourly price cap.
• Nursing services and capital supports see an increase, with nursing services getting more than a 3% bump.
• Dietetics sees a 5.2% reduction, ‘other professionals’ under allied health a 20% reduction, and exercise physiology a 3% reduction. The hits keep coming.
• Psychology and specialist behaviour support rates are going in the other direction, with an 8% increase.
• Short Term Accommodation (STA) now has separate item numbers for support hours and accommodation.

For a few service modalities, the Pricing Schedule also introduces new item numbers. Allied health now has specific item numbers for each service:

• Cancellation is the usual item number with the suffix _CA
• Non-face-to-face adds the suffix _NF
• Provider travel adds the suffix _PT
• NDIA requested support adds the suffix _RR
• Telehealth adds the suffix _TH

Undoubtedly, this adds complexity to billing, with the need to better integrate your CRM and finance systems, to ensure accurate claiming. It’s more data, sure, but that’s now the norm.

What remains the same?

There’s less good here, but much of it is unsurprising:

• Plan management and support coordination face another freeze.
• Any allied health not mentioned above faces another freeze.

Differentiated Pricing

Last year, we explored the NDIA’s proposed differentiated pricing model, and the most recent APR seemingly suggested that the agency is serious in its implementation. But in a surprise twist, the Pricing Schedule didn’t explicitly adopt the APR’s recommendations.

The APR proposed a 10% reduction in the price limit for unregistered providers that deliver social, community, and civic participation. It even set a start date from January 2027, meaning unregistered providers would have a six-month lead in.

Interestingly though, the Pricing Schedule didn’t adopt the APR’s recommendation, meaning we know have to wait and see if it will come into effect on January 2026. But we know with certainty that differentiated pricing remains firmly on the Government’s agenda.

The Government’s Reform

We need to note that the Government’s reform package, currently in limbo while the senate inquiry rolls on, would give the Minister the power to set prices – superseding what’s listed in the Pricing Schedule. For participants and providers alike, it’s a nerve-wracking proposition.

We now need to wait to see if the legislation in its current form will pass, despite vocal opposition from participants, or if the senate inquiry will result in the Government making last-minute changes.

The gist: trust the Pricing Schedule, but keep an eye on the current inquiry, because things might change again, very quickly.